Changes in Sexual Function Following Bariatric Surgery
The main purposes of the study are to compare changes in sexual function, changes in sex hormones, and changes in body image and marital satisfaction at 12, 24, 36 and 48 months postoperatively in two groups: individuals who undergo a bariatric surgical procedure and extremely obese individuals with similar obesity-related comorbidities who do not seek surgery (treatment comparison group).
The mechanisms by which extreme obesity affects sexual functioning have received little attention. Recent epidemiologic studies suggest that obesity and physical inactivity are independently related to the likelihood of developing sexual dysfunction over time. For example, men with a BMI greater than 29 kg/m2 have a 30% greater risk of developing erectile dysfunction and up to 50 % of ED cases can be attributed to hypertension and cardiovascular disease, both commonly associated with obesity. Many treatments for hypertension have also been shown to interfere with sexual function.
Changes in sex hormones with increasing BMI have not received much attention either. Obesity has been associated with decreases in testosterone and sex hormone binding globulin for men and increases in testosterone and estrogen for women. Several studies have shown improvement in sex hormone levels in both men and women following weight loss. Sexual functioning has never been assessed in association with weight loss and whether through improvements in body image, sex hormones, or obesity related comorbidities, bariatric surgery may have a profound effect on sexual functioning.
Dr. Ray Rosen, the Principal investigator for this sub study, has conducted a previous investigation focused on sexual functioning after weight loss in a behavioral weight loss program. Specifically, he looked at short and long term sexual function outcomes associated with Type-2 diabetes. His previous work in this area has shown that patients are willing to participate in studies of sexual function.
The Psychosocial Changes study assesses sexual function in two ways. Participants first fill out a packet of questionnaires covering topics related to depression, quality of life, body image, and marital and sexual functioning. They also give a blood sample in order for us to assess levels of sex hormones including testosterone, luteinizing hormone, estradiol, follicle stimulating hormone, and others.
|Obesity||Procedure: Bariatric surgery Behavioral: lifestyle intervention (behavioral weight loss)|
|Study Design:||Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Screening
|Official Title:||Psychosocial Changes Associated With Weight Loss|
- Sexual functioning as measured by the International Index for Erectile Dysfunction (for men) and the Female Sexual Function Inventory (for women) [ Time Frame: 48 months ]
- sex hormones [ Time Frame: 48 months ]
- body image (Body Shape Questionnaire and The Body Image Quality of Life Questionnaire) [ Time Frame: 48 months ]
- relationship functioning (Dyadic Adjustment Scale) [ Time Frame: 48 months ]
- quality of life (Impact of Weight on Quality of Life questionnaire and Medical Short Form Survey) [ Time Frame: 48 months ]
|Study Start Date:||August 2005|
|Study Completion Date:||September 2013|
|Primary Completion Date:||October 2007 (Final data collection date for primary outcome measure)|
Procedure: Bariatric surgery
patients receive either gastric bypass or lap-band
Behavioral: lifestyle intervention (behavioral weight loss)
participants attend biweekly weight loss counseling group sessions